Value of 3D reconstructions in pancreatic surgery: Current status - 22/10/25

Doi : 10.1016/j.jviscsurg.2025.09.011

Edouard Roussel ^a,^b,^c,⁎ , Jean Pinson ^a,^c, Lola Duhamel ^a,^d, Paul Martre ^e, Gaetan Kerdelhué ^f, Jean-Jacques Tuech ^a, Lilian Schwarz ^a,^g
^a Rouen University Hospital, Department of Digestive Surgery, 76000 Rouen, France
^b Medical Training Centre (MTC), Rouen University Hospital, 76000 Rouen, France
^c Normandy University, UNIROUEN, Integrated Multimodal Health Analysis (AIMS), Rouen University Hospital, 76000 Rouen, France
^d Normandy University, UNIROUEN, QuantIF-LITIS EA 4108, 76000 Rouen, France
^e Hôpital Privé de l’Estuaire, 76620 Le Havre, France
^f Rouen University Hospital, Department of Digital Health, 76000 Rouen, France
^g Normandy University, UNIROUEN, UMR 1245 Inserm, Rouen University Hospital, Department of Genomic and Personalised Medicine in Cancer and Neurological Disorders, 76000 Rouen, France

^⁎Corresponding author at: Département de chirurgie digestive et transplantation, CHU de Rouen, 2, rue de Germont, 76000 Rouen, France.Département de chirurgie digestive et transplantation, CHU de Rouen2, rue de GermontRouen76000France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 22 October 2025

Highlights

•	Three-dimensional (3D) reconstruction improves preoperative planning by enhancing the detection of anatomical variations and the evaluation of resection margins.
•	3D reconstruction of residual tumor and pancreatic volume, could be of prognostic value by improving the prediction of morbidity and mortality and the risk of recurrence.
•	3D-assisted surgical navigation has been found to be associated with reduced blood loss and operation duration in several studies.
•	In terms of teaching, augmented reality and 3D printing facilitate learning surgical anatomy.
•	High-quality comparative studies are still needed to determine the potential for standardization before possible integration into current practice.

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Summary

Introduction

Three-dimensional (3D) reconstruction transforms cross-sectional medical images into interactive anatomical models, interpretable on an LCD screen, in augmented reality or via 3D printing. Although certain benefits have been established in liver surgery, its use in pancreatic surgery remains limited. This update outlines the applications of 3D visualization in pancreatic surgery, ranging from surgical planning to teaching.

Method

A systematic search for English-language articles reporting 3D pancreatic reconstructions in adult patients was conducted in PubMed, Web of Science, Lens.org and the Cochrane Library up to August 28, 2024. Of 1650 articles initially identified, 34 were retained after exclusion of duplicate publications and analysis of titles, abstracts and texts.

Results

The analysis of these studies suggests that 3D reconstruction, in comparison to cross-sectional imaging, could improve preoperative evaluation, by facilitating the detection of anatomical variations, the assessment of resection margins, and the prediction of morbidity and mortality according to tumor volume and residual pancreatic parenchyma. 3D imaging could also improve intraoperative safety, with some series reporting a 50% reduction of blood loss and a 25% reduction in operating time. 3D reconstruction is also a promising tool for teaching surgical anatomy, particularly through 3D printing.

Conclusion

3D reconstruction could improve outcomes of pancreatic surgery but requires robust comparative studies before becoming a standard evidence-based practice.

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Keywords : Pancreatic surgery, 3D, Augmented reality, 3D printing, Pancreatic cancer